The prognostic value of immunoscore in the early-onset colorectal cancer
Abstract Background The purpose of this study was to explore the prognostic value of Immunoscore in patients with early-onset colorectal cancer. Methods We retrospectively analyzed 708 colorectal adenocarcinoma patients (2017–2020), ultimately including 36 early-onset colorectal cancer cases after e...
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BMC
2025-07-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-025-04055-y |
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| author | Xinchun Wu Sen Hou Yingjiang Ye Zhidong Gao |
| author_facet | Xinchun Wu Sen Hou Yingjiang Ye Zhidong Gao |
| author_sort | Xinchun Wu |
| collection | DOAJ |
| description | Abstract Background The purpose of this study was to explore the prognostic value of Immunoscore in patients with early-onset colorectal cancer. Methods We retrospectively analyzed 708 colorectal adenocarcinoma patients (2017–2020), ultimately including 36 early-onset colorectal cancer cases after exclusions. CD3+/CD8 + lymphocytes were quantified using immunohistochemistry and a self-trained neural network model from Cellpose 2.0. Immunoscore was calculated based on T cell densities in tumor cores and invasive margins, stratified as high or low. Prognostic associations were assessed via Kaplan-Meier analysis, Cox regression, and restricted cubic spline models. Results of Cox regression was validated by post-hoc analysis. Results Of all early-onset colorectal cancer patients, 23(63.9%) patients were graded as Immunoscore-high, 13(36.1%) were graded as Immunoscore-low. The self trained model achieved high consistency with manual counting. High Immunoscore correlated with earlier clinical stages (stage I/II: P = 0.011), reduced metastasis risk (N0, P = 0.042; M0, P = 0.009), and lower mortality (P = 0.009). Univariate Cox regression analysis identified Immunoscore as a possible predictor for overall survival (Hazard Ratio = 5.82, P = 0.030) and progression free survival (Hazard Ratio = 3.68, P = 0.014). The Post-hoc power analysis showed the type II error probability (β) of univariate Cox analysis for overall survival with a hazard ratio of 5.82 was 0.282 (28.2%), while for progression free survival with a hazard ratio of 3.68, β was 0.006 (0.6%). Restricted cubic spline showed that the influence of CD3+/CD8 + cells in different region on prognosis was not simply linear. Although Immunoscore didn’t remain statistically significant as an independent predictor of OS (Hazard Ratio = 4.76; P = 0.138) and PFS (Hazard Ratio = 1.83; P = 0.360) in multivariate Cox regression analysis, stratified Kapan-Meier curves by MMR status and clinical stage showed well separation. Conclusion Immunoscore can serve as a possible indicator in predicting prognosis of patients with early-onset colorectal cancer, but still need large sample research validation. |
| format | Article |
| id | doaj-art-c66726b513cb4366b666d76261d6e51a |
| institution | Kabale University |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj-art-c66726b513cb4366b666d76261d6e51a2025-08-20T03:42:57ZengBMCBMC Gastroenterology1471-230X2025-07-0125111310.1186/s12876-025-04055-yThe prognostic value of immunoscore in the early-onset colorectal cancerXinchun Wu0Sen Hou1Yingjiang Ye2Zhidong Gao3Department of Gastrointestinal Surgery, Peking University People’s HospitalDepartment of Gastrointestinal Surgery, Peking University People’s HospitalDepartment of Gastrointestinal Surgery, Peking University People’s HospitalDepartment of Gastrointestinal Surgery, Peking University People’s HospitalAbstract Background The purpose of this study was to explore the prognostic value of Immunoscore in patients with early-onset colorectal cancer. Methods We retrospectively analyzed 708 colorectal adenocarcinoma patients (2017–2020), ultimately including 36 early-onset colorectal cancer cases after exclusions. CD3+/CD8 + lymphocytes were quantified using immunohistochemistry and a self-trained neural network model from Cellpose 2.0. Immunoscore was calculated based on T cell densities in tumor cores and invasive margins, stratified as high or low. Prognostic associations were assessed via Kaplan-Meier analysis, Cox regression, and restricted cubic spline models. Results of Cox regression was validated by post-hoc analysis. Results Of all early-onset colorectal cancer patients, 23(63.9%) patients were graded as Immunoscore-high, 13(36.1%) were graded as Immunoscore-low. The self trained model achieved high consistency with manual counting. High Immunoscore correlated with earlier clinical stages (stage I/II: P = 0.011), reduced metastasis risk (N0, P = 0.042; M0, P = 0.009), and lower mortality (P = 0.009). Univariate Cox regression analysis identified Immunoscore as a possible predictor for overall survival (Hazard Ratio = 5.82, P = 0.030) and progression free survival (Hazard Ratio = 3.68, P = 0.014). The Post-hoc power analysis showed the type II error probability (β) of univariate Cox analysis for overall survival with a hazard ratio of 5.82 was 0.282 (28.2%), while for progression free survival with a hazard ratio of 3.68, β was 0.006 (0.6%). Restricted cubic spline showed that the influence of CD3+/CD8 + cells in different region on prognosis was not simply linear. Although Immunoscore didn’t remain statistically significant as an independent predictor of OS (Hazard Ratio = 4.76; P = 0.138) and PFS (Hazard Ratio = 1.83; P = 0.360) in multivariate Cox regression analysis, stratified Kapan-Meier curves by MMR status and clinical stage showed well separation. Conclusion Immunoscore can serve as a possible indicator in predicting prognosis of patients with early-onset colorectal cancer, but still need large sample research validation.https://doi.org/10.1186/s12876-025-04055-yEarly onset colorectal cancerMachine learningCellpose 2.0Immunoscore |
| spellingShingle | Xinchun Wu Sen Hou Yingjiang Ye Zhidong Gao The prognostic value of immunoscore in the early-onset colorectal cancer BMC Gastroenterology Early onset colorectal cancer Machine learning Cellpose 2.0 Immunoscore |
| title | The prognostic value of immunoscore in the early-onset colorectal cancer |
| title_full | The prognostic value of immunoscore in the early-onset colorectal cancer |
| title_fullStr | The prognostic value of immunoscore in the early-onset colorectal cancer |
| title_full_unstemmed | The prognostic value of immunoscore in the early-onset colorectal cancer |
| title_short | The prognostic value of immunoscore in the early-onset colorectal cancer |
| title_sort | prognostic value of immunoscore in the early onset colorectal cancer |
| topic | Early onset colorectal cancer Machine learning Cellpose 2.0 Immunoscore |
| url | https://doi.org/10.1186/s12876-025-04055-y |
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